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1.
Oxid Med Cell Longev ; 2022: 5628946, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35910837

RESUMO

Age-related cataract (ARC) is the common cause of blindness globally. Reactive oxygen species (ROS), one of the greatest contributors to aging process, leads to oxidative damage and senescence of lens epithelial cells (LECs), which are involved in the pathogenesis of ARC. Biliverdin reductase A (BVRA) has ROS-scavenging ability by converting biliverdin (BV) into bilirubin (BR). However, little is known about the protective effect of BVRA against ARC. In the present study, we measured the expression level of BVRA and BR generation in human samples. Then, the antioxidative property of BVRA was compared between the young and senescent LECs upon stress condition. In addition, we evaluated the effect of BVRA on attenuating H2O2-induced premature senescence in LECs. The results showed that the mRNA expression level of BVRA and BR concentration were decreased in both LECs and lens cortex of age-related nuclear cataract. Using the RNA interference technique, we found that BVRA defends LECs against oxidative stress via (i) restoring mitochondrial dysfunction in a BR-dependent manner, (ii) inducing heme oxygenase-1 (HO-1) expression directly, and (iii) promoting phosphorylation of ERK1/2 and nuclear delivery of nuclear factor erythroid 2-related factor 2 (Nrf2). Intriguingly, the antioxidative effect of BVRA was diminished along with the reduced BR concentration and repressed nuclear translocation of BVRA and Nrf2 in senescent LECs, which would be resulted from the decreased BVRA activity and impaired nucleocytoplasmic trafficking. Eventually, we confirmed that BVRA accelerates the G1 phase transition and prevents against H2O2-induced premature senescence in LECs. In summary, BVRA protects LECs against oxidative stress and cellular senescence in ARC by converting BV into BR, inducing HO-1 expression, and activating the ERK/Nrf2 pathway. This trial is registered with ChiCTR2000036059.


Assuntos
Catarata , Fator 2 Relacionado a NF-E2 , Antioxidantes/farmacologia , Bilirrubina/metabolismo , Catarata/patologia , Senescência Celular , Células Epiteliais/metabolismo , Fator de Transcrição de Proteínas de Ligação GA/metabolismo , Heme Oxigenase-1/genética , Heme Oxigenase-1/metabolismo , Humanos , Peróxido de Hidrogênio/farmacologia , Fator 2 Relacionado a NF-E2/metabolismo , Estresse Oxidativo , Oxirredutases atuantes sobre Doadores de Grupo CH-CH , Espécies Reativas de Oxigênio/metabolismo
2.
J Refract Surg ; 38(8): 480-486, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35947005

RESUMO

PURPOSE: To evaluate the predictors related to the efficacy of epithelium- and Bowman membrane-penetrating femtosecond laser-assisted arcuate keratotomy (FSAK) in the treatment of preoperative astigmatism in patients with cataracts and to clarify the predictive role of the incision-to-limbus distance. METHODS: This retrospective study included patients who underwent femtosecond laser-assisted cataract surgery combined with FSAK using the LenSX platform (Alcon Laboratories, Inc) at Beijing Aier-Intech Eye Hospital from March 2017 to December 2021. The Lenstar LS900 (Haag-Streit, Inc) was used to measure the horizontal corneal diameter, and ImageJ software (National Institutes of Health) was used to measure the vertical corneal diameter and incision-to-limbus distance. Finally, the measured values were converted. Changes in corneal astigmatism before and 3 months after surgery were analyzed using Alpins vector analysis. Correlation analysis and regression analysis were used to evaluate the factors associated with surgically induced astigmatism (SIA) in preoperative ocular biometric parameters. RESULTS: The study included 94 eyes of 94 patients. The mean target induced astigmatism was 1.36 ± 0.44 diopters (D), SIA was 0.82 ± 0.43 D, and mean difference vector was 0.70 ± 0.40 D. Pearson correlation analysis and univariate regression analysis showed that preoperative corneal astigmatism, arcuate keratotomy arc length, incision-to-limbus distance, and astigmatism type were significant predictors of SIA. Multiple variable regression analysis included parameters such as age, arcuate keratotomy arc length, and incision-to-limbus distance and established a multiple regression model of SIA (all P < .01). CONCLUSIONS: The incision-to-limbus distance was a significant independent predictor of SIA, and inclusion of this parameter may further improve the accuracy of the nomogram. [J Refract Surg. 2022;38(8):480-486.].


Assuntos
Astigmatismo , Catarata , Doenças da Córnea , Astigmatismo/complicações , Astigmatismo/cirurgia , Catarata/complicações , Córnea/cirurgia , Doenças da Córnea/cirurgia , Topografia da Córnea , Humanos , Lasers , Refração Ocular , Estudos Retrospectivos , Acuidade Visual
3.
FP Essent ; 519: 19-23, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35947132

RESUMO

Primary open-angle glaucoma (POAG) is a progressive, chronic, irreversible ocular disease that leads to loss of visual field. In the United States, its prevalence is expected to more than double from 2011 to 2050. POAG is three times more common among Black people than White people. More than half of patients with POAG are asymptomatic. Management focuses on decreasing intraocular pressure. Prostaglandin analogue eye drops can preserve visual field and are the first-line therapy. There currently is no evidence to support universal screening for POAG in adults. Physicians should recognize patients at high risk and provide early referral to an ophthalmologist. They also should encourage patients with POAG to adhere to treatment and follow up with their ophthalmologist. Cataract is a progressive condition caused by opacification of the lens of the eye. It affects 24.4 million Americans and is expected to affect 50 million Americans by 2050. Patients with cataracts present with visual impairment, glare, decreased color and contrast sensitivity, and poor adaptation to darkness. Management consists of surgical removal of the lens via small-incision phacoemulsification with placement of a foldable intraocular lens. After surgery, patients may develop posterior capsular opacification, which can be managed with laser capsulotomy.


Assuntos
Catarata , Glaucoma de Ângulo Aberto , Facoemulsificação , Adulto , Catarata/diagnóstico , Catarata/etiologia , Catarata/terapia , Glaucoma de Ângulo Aberto/diagnóstico , Glaucoma de Ângulo Aberto/etiologia , Glaucoma de Ângulo Aberto/terapia , Humanos , Pressão Intraocular , Facoemulsificação/efeitos adversos
4.
Proc Nutr Soc ; 81(2): 190-198, 2022 May.
Artigo em Inglês | MEDLINE | ID: mdl-35934687

RESUMO

The concept of plant-based diets has become popular due to the purported benefits for both human health and environmental impact. Although 'plant-based' is sometimes used to indicate omnivorous diets with a relatively small component of animal foods, here we take it to mean either vegetarian (plant-based plus dairy products and/or eggs) or vegan (100% plant-based). Important characteristics of plant-based diets which would be expected to be beneficial for long-term health are low intakes of saturated fat and high intakes of dietary fibre, whereas potentially deleterious characteristics are the risk of low intakes of some micronutrients such as vitamin B12, vitamin D, calcium and iodine, particularly in vegans. Vegetarians and vegans typically have lower BMI, serum LDL cholesterol and blood pressure than comparable regular meat-eaters, as well as lower bone mineral density. Vegetarians in the EPIC-Oxford study have a relatively low risk of IHD, diabetes, diverticular disease, kidney stones, cataracts and possibly some cancers, but a relatively high risk of stroke (principally haemorrhagic stroke) and bone fractures, in comparison with meat-eaters. Vegans in EPIC-Oxford have a lower risk of diabetes, diverticular disease and cataracts and a higher risk of fractures, but there are insufficient data for other conditions to draw conclusions. Overall, the health of people following plant-based diets appears to be generally good, with advantages but also some risks, and the extent to which the risks may be mitigated by optimal food choices, fortification and supplementation is not yet known.


Assuntos
Catarata , Doenças Diverticulares , Animais , Dieta , Dieta Vegana , Dieta Vegetariana , Humanos
5.
BMC Ophthalmol ; 22(1): 336, 2022 Aug 08.
Artigo em Inglês | MEDLINE | ID: mdl-35941541

RESUMO

BACKGROUND: Severe intraocular hemorrhage is a rare complication of cataract surgery due to the recent generalization of minimal-incision cataract surgery. We report a case of a massive intraocular hemorrhage that probably originated from the central retinal artery after cataract surgery, in which hemostasis was difficult to achieve during vitrectomy. CASE PRESENTATION: An 86-year-old woman was referred to our department for intraocular lens (IOL) dislocation after undergoing cataract surgery. Massive intraocular hemorrhage was observed during the initial visit to our department. She underwent pars plana vitrectomy (PPV) and IOL repositioning under local anesthesia. However, the hemorrhage could not be removed completely because of continued massive intraoperative bleeding from the posterior fundus, and it was extremely difficult to achieve hemostasis during the initial surgery. At 7 days after the initial surgery, PPVs were performed under general anesthesia. Bleeding significantly decreased in the second surgery compared to the first. The bleeding probably originated from the central retinal artery on the optic disc; hemostasis was obtained by coagulation of the bleeding site with intraocular diathermy. After the second surgery, there was no exacerbation of bleeding and the patient's condition was stable. However, the patient's visual acuity showed no light perception after the second surgery. CONCLUSIONS: Massive intraocular hemorrhage may occur from the central retinal artery after undergoing cataract surgery. In such cases, surgery with general anesthesia with a lower maintained blood pressure (instead of surgery under local anesthesia) should be recommended, considering the possibility of difficult hemostasis in the event of bleeding from the retinal artery.


Assuntos
Extração de Catarata , Catarata , Oftalmopatias , Hemorragia Ocular , Lentes Intraoculares , Artéria Retiniana , Idoso de 80 Anos ou mais , Catarata/complicações , Extração de Catarata/efeitos adversos , Oftalmopatias/complicações , Hemorragia Ocular/cirurgia , Feminino , Hemostasia , Humanos , Implante de Lente Intraocular/efeitos adversos , Complicações Pós-Operatórias/cirurgia , Estudos Retrospectivos , Vitrectomia/efeitos adversos
6.
BMC Ophthalmol ; 22(1): 341, 2022 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-35948879

RESUMO

BACKGROUND: The aim was to evaluate the safety and efficacy of a trifocal intraocular lens (IOL) for the correction of presbyopia and to assess patient satisfaction. METHODS: Records from three centres were reviewed to select presbyopic patients having undergone bilateral refractive lens exchange and implantation of the AT LISA tri 839MP multifocal IOL. Postoperatively, monocular and binocular distance, intermediate and near visual acuities, corrected and uncorrected, and subjective refraction were measured. Patients also completed a quality of life questionnaire. Safety evaluation included IOL stability and postoperative complications. RESULTS: 72 eyes (36 patients) were analysed. No clinically significant difference between pre- and postoperative corrected distance visual acuity (CDVA) was found for monocular or binocular measurements. Mean postoperative monocular CDVA was 0.02 ± 0.04 logMAR. Mean refractive values all improved statistically significantly compared with preoperative baseline (p ≤ 0.0064). Overall, 82.4% of eyes had spherical equivalent within ± 0.5 D and 97.1% within ± 1.0 D of emmetropia with a mean accuracy of -0.10 ± 0.41 D. Spectacle independence for distance, intermediate and near visual acuity was 87.5%, 84.4% and 78.1% respectively, and 78.1% of patients were satisfied with their postoperative, spectacle-free vision. Eight eyes received Nd:YAG laser treatment. No other IOL-related safety issues were reported. CONCLUSION: AT LISA tri 839MP multifocal IOL bilaterally implanted in presbyopic patients provided excellent distance, intermediate and near visual outcomes with very accurate correction of refraction. These results were associated with a high level of spectacle independence and patient satisfaction. TRIAL REGISTRATION: Trial registered on https://clinicaltrials.gov/ under the identification NCT03790592 (31/12/2018).


Assuntos
Catarata , Lentes Intraoculares , Humanos , Satisfação do Paciente , Estudos Prospectivos , Desenho de Prótese , Pseudofacia/cirurgia , Qualidade de Vida , Refração Ocular
7.
BMC Ophthalmol ; 22(1): 340, 2022 Aug 10.
Artigo em Inglês | MEDLINE | ID: mdl-35948897

RESUMO

BACKGROUND: This study is aimed to assess the association between asthma and cataract in a representative sample in the United States. METHODS: The National Health Interview Survey (NHIS) is the principal source of information on the health of the civilian noninstitutionalized population of the United States. Ten years (2010-2019) of NHIS were analyzed in this study. Asthma and cataract status were collected from relevant questionnaires among participants aged 40 years and older. Multivariate regression analyses were applied to explore the association between asthma and cataract. RESULTS: From 40,457 participants included, those with asthma had higher prevalence of cataract than those without asthma (29.41% vs 25.87%, p < 0.001). Participants who had asthma had 40% higher odds of cataract compared to those without, after adjusting for potential confounding covariates (Odds Ratio [OR] = 1.40, 95% Confidence Interval [CI]: 1.29-1.52, p < 0.001). When viewing asthma as the outcome, participants who had cataract had 36% higher odds of asthma compared to those without, after adjusting for potential confounding covariates (Odds Ratio [OR] = 1.36, 95% Confidence Interval [CI]: 1.25-1.47, p < 0.001). CONCLUSIONS: With our study, we demonstrated that individuals with asthma were more likely to develop cataract compared with those without asthma. Further RCTs are needed to confirm this potential impact of asthma on cataract and to investigate the underlying mechanisms.


Assuntos
Asma , Catarata , Adulto , Asma/complicações , Asma/epidemiologia , Catarata/epidemiologia , Estudos Transversais , Humanos , Pessoa de Meia-Idade , Razão de Chances , Prevalência , Estados Unidos/epidemiologia
8.
J Cataract Refract Surg ; 48(8): 974, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35916482

RESUMO

A 27-year-old woman had BrightOcular iris implants placed for cosmetic purposes that changed eye color from brown to blue bilaterally. Of note, BrightOcular implants are not approved by the U.S. Food and Drug Administration (FDA) for use in the United States and have been associated with severe ocular complications. In keeping with their design, they were placed in the anterior chamber (AC) in both eyes of this patient; surgery was performed outside the United States. As has been described previously and tragically in other cases, she developed chronic inflammation, intolerable glare, angle-closure glaucoma, corneal edema, and cataracts in both eyes. For medically unmanageable elevated intraocular pressure (IOP), she underwent diode laser cyclophotocoagulation (CPC) in both eyes, and eventually, an Ahmed tube shunt (New World Medical, Inc.) was placed in the right eye. Although she was advised and urged to have the iris implants removed, despite her ocular issues, she refused removal until intolerable glare and reduced vision ensued. Ultimately, both iris implants were extracted 5 years after implantation by a U.S. surgeon; the procedures resulted in corneal decompensation and progressive cataract development. Subsequent penetrating keratoplasty (PKP) was performed for the right eye, but it failed because of contact with the glaucoma tube shunt. She sought additional consultation and presented with the following findings: corrected distance visual acuity was 20/400 in the right eye and 20/40 in the left eye, IOP of 18 mm Hg in the right eye and 16 mm Hg in the left eye, pupils were nonreactive and fixed, and extraocular muscles and central visual field were normal. Pachymetry was 868 µm in the right eye and 653 µm in the left eye. Anterior segment examination in the right eye revealed a failed corneal graft with 3+ edema, peripheral anterior synechiae (PAS) for 360 degrees, shallow AC, Ahmed tube shunt at the 11 o'clock position and remnant iris adherent to the graft-host junction for 270 degrees, 3+ posterior subcapsular cataract, and 2+ cortical cataract (Figure 1JOURNAL/jcrs/04.03/02158034-202208000-00024/figure1/v/2022-08-01T210317Z/r/image-tiff). The sclera revealed multiple circular and circumferential atrophic blue spots consistent with high-energy transscleral CPC (Figure 2JOURNAL/jcrs/04.03/02158034-202208000-00024/figure2/v/2022-08-01T210317Z/r/image-tiff). In the left eye, she had remnant fixed dilated iris for 270 degrees, missing iris superiorly for 3 clock hours, an adequate AC, and 2+ cortical cataract (Figure 3JOURNAL/jcrs/04.03/02158034-202208000-00024/figure3/v/2022-08-01T210317Z/r/image-tiff). Posterior segment examination revealed a 0.5 cup-to-disc ratio in both eyes with normal vessels, macula, vitreous, and retinal periphery, bilaterally. Given this constellation of findings, how would you proceed?


Assuntos
Catarata , Implantes para Drenagem de Glaucoma , Adulto , Câmara Anterior/cirurgia , Feminino , Implantes para Drenagem de Glaucoma/efeitos adversos , Humanos , Pressão Intraocular , Iris/cirurgia
9.
Curr Opin Ophthalmol ; 33(5): 453-463, 2022 Sep 01.
Artigo em Inglês | MEDLINE | ID: mdl-35916572

RESUMO

PURPOSE OF REVIEW: To review all phakic intraocular lenses (pIOLs) available in the United States for the correction of myopia or myopic astigmatism and offer a clinical approach to their proper use, postoperative follow-up, and analysis of visual and adverse outcomes. RECENT FINDINGS: In March 2022, the FDA approved the EVO/EVO+ Visian ICL for widespread use, adding this lens to the two others available (Verisyse, Visian ICL). Cataract formation, endothelial cell loss (ECL) and surgical reintervention remain the most common adverse events. There are discrepancies between studies on ECL following implantation with pIOLs, although trends can be deduced with meta-analysis. Posterior Chamber-pIOLs (PC-pIOLs), especially the EVO/EVO+, have an overall lower mean adverse effect and subjective patient symptom profile when compared to Iris Fixated-pIOLS (IF-pIOLs). Advancements in PC-pIOL sizing have provided a noticeable difference in visual and safety outcomes. SUMMARY: All pIOLs available in the United States provide high-quality visual correction of moderate to high myopia and/or myopia with astigmatism. Proper follow-up for ECL and cataract formation is warranted.


Assuntos
Astigmatismo , Catarata , Lentes Intraoculares , Miopia , Lentes Intraoculares Fácicas , Astigmatismo/cirurgia , Catarata/etiologia , Seguimentos , Humanos , Miopia/cirurgia , Lentes Intraoculares Fácicas/efeitos adversos , Refração Ocular , Estados Unidos , Acuidade Visual
10.
Rom J Ophthalmol ; 66(2): 185-190, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935079

RESUMO

Anterior uveitis is the most common extra-articular manifestation in children diagnosed with Juvenile idiopathic arthritis (JIA). It is typically a non-granulomatous, chronic, and asymptomatic uveitis. The lack of acute symptoms often delays the diagnosis with the incidence of severe ocular complications. Chorioretinitis lesions have been described in only 1% of cases. The absence of fundus changes can be explained by the impossibility of performing fundoscopy through the cloudy ocular media, secondary to inflammation. A 7-year-old female with a 3-month history of painless reduced vision came to have an eye examination. An initial diagnosis of bilateral anterior granulomatous uveitis complicated with glaucoma and cataract was formulated. Because of the concomitant diagnosis of COVID-19 disease (same day as the eye examination), the child was hospitalized in a hometown COVID-19 patient ward, so both local and general treatment, monitorization, and investigations were discontinued. The following eye examination revealed the persistence of anterior uveitis, inflammatory glaucoma, cataract, and the appearance of band keratopathy. Fundoscopy revealed numerous disseminated lesions of choroiditis. Further examinations established JIA-associated uveitis diagnosis, so systemic corticosteroids were initiated followed by Methotrexate and Adalimumab. Monitoring with fundoscopy in a patient diagnosed with JIA-U is necessary to detect possible chorioretinal or vascular damage. Abbreviations: BVA = best visual acuity, CVA = corrected visual acuity, CS = corticosteroids, IOP = Intraocular pressure, JIA = Juvenile idiopathic arthritis, JIA-U = Juvenile idiopathic arthritis associated uveitis, LE = left eye, MTX = Methotrexate, OU = both eyes, OCT = Optical Coherence Tomography, RE = right eye, TNF = tumor necrosis factor.


Assuntos
Artrite Juvenil , COVID-19 , Catarata , Glaucoma , Uveíte Anterior , Uveíte Posterior , Uveíte , Artrite Juvenil/complicações , Artrite Juvenil/diagnóstico , COVID-19/complicações , COVID-19/diagnóstico , Catarata/complicações , Criança , Feminino , Glaucoma/complicações , Humanos , Metotrexato , Uveíte/etiologia , Uveíte Anterior/diagnóstico , Uveíte Anterior/tratamento farmacológico , Uveíte Anterior/etiologia , Uveíte Posterior/diagnóstico , Uveíte Posterior/tratamento farmacológico , Uveíte Posterior/etiologia
11.
Rom J Ophthalmol ; 66(2): 132-134, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935087

RESUMO

Introduction: Advances in technology and technique have led to a significant improvement in the prognosis after cataract surgery. However, there are complications that can significantly affect this prognosis, such as posterior capsule rupture and corneal decompensation. For vitreous prolapse associated with posterior capsule rupture, classic or pars plana anterior vitrectomy is required. Aim: The aim of the study was to compare corneal endothelial cell destruction after cataract surgery associated with posterior capsule rupture and classical and pars plana anterior vitrectomy, respectively. Material and method: The study was prospective, on 12 consecutive cases of cataract surgery associated with posterior capsule rupture. Classical anterior vitrectomy was performed in group A, with 5 patients, while pars plana anterior vitrectomy was performed in group B. For all cases, the Stellaris phacoemulsification device (Baush & Lomb, tm) and the associated vitrectomy device was used. Results: Pars plana anterior vitrectomy had a statistically significant lower rate of corneal endothelial damage, both in absolute value and as a percentage of initial density. Conclusions: Pars plana anterior surgery is a somewhat unfamiliar technique for anterior pole surgeons. But it is easy to learn and brings a decrease in the rate of damage to the corneal endothelium.


Assuntos
Opacificação da Cápsula , Extração de Catarata , Catarata , Facoemulsificação , Extração de Catarata/métodos , Endotélio Corneano , Humanos , Estudos Prospectivos , Vitrectomia/métodos
12.
Rom J Ophthalmol ; 66(2): 135-139, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35935089

RESUMO

Objective: To compare the number of surge events and efficacy of phacoemulsification using a near-physiological intraocular pressure (IOP) setting and a standard IOP setting. Materials and methods: The surgical data of patients who underwent phacoemulsification with IOL implantation using the CENTURION Vision System's Active Fluidics setting and Active Sentry Handpiece (Alcon Laboratories, USA) were analyzed. Results: The study included 181 patients (204 eyes). In Group 1, the IOP was set at 20 mmHg (n=102, 50%), and in Group 2, the IOP was set at 60 mmHg (n=102, 50%). Total case time was significantly lower (p=.036) in Group 1 (0:03:17.20 ± 0:00:34.55 vs. 0:03:28.71 ± 0:00:43.03). There was no statistically significant difference between the mean cumulative dissipated energy (CDE) (7.06 ± 3.20 vs. 7.59 ± 3.26) and mean ultrasound (UJS) time (0:00:36 ± 0:00:12 vs. 0:00:38 ± 0:00:13) between the two groups (p=0.24 and p=0.31, respectively). Active sentry (AS) engaged less often (p<0.001) in Group 1. There was no statistically significant correlation between the CDE and AS activation in Group 1 (p=0.96). A strong statistically significant correlation between the CDE and AS activation (p<0.0001, r=0.61, CI (0.47 to 0.72)) was observed in group 2. Conclusion: During phacoemulsification, surge events are more likely to occur when operating at high IOP settings. Abbreviations: LIPMICS = low infusion pressure microincision cataract surgery, IOP = intraocular pressure, CDE = cumulative dissipated energy, UJS = mean ultrasound time, AS = Active sentry, LOCS = Lens Opacities Classification System, NO = nuclear opalescence, AFR = aspiration flow rate.


Assuntos
Extração de Catarata , Catarata , Facoemulsificação , Humanos , Pressão Intraocular , Implante de Lente Intraocular , Estudos Prospectivos
13.
BMC Ophthalmol ; 22(1): 331, 2022 Aug 03.
Artigo em Inglês | MEDLINE | ID: mdl-35922795

RESUMO

PURPOSE: The aim of this study was evaluate the effect of governmental support in the form of Health Transformation Plan (HTP) on increasing the cataract surgical rate. METHODS: The number of cataract surgeries was collected from Iranian cataract surgery clinics during 2019. HTP was implemented in 2014. Forty-seven major and forty-five minor surgery centers were selected from all provinces. In each center, sampling was done from 2012, 2013, 2015, and 2016. RESULTS: On average, 6202 and 7134 cataract surgery rate were performed before and after HTP, respectively. The cataract surgical rate rose by 15.03% after the HTP. After HTP, the proportion of cataract surgery increased by 21.32% in governmental centers and decreased by 17.56%, 24.45%, and 14.89% in private, insurance, and charity centers, respectively. The cataract surgical rate was 4093 and 6026 in the first economic quartile (the poorest), 3669 and 4595 in the second quartile, 5884 and 5928 in the third quartile, and 8427 and 9681 in the fourth quartile (the richest) before and after HTP, respectively. The highest growth in the cataract surgical rate was seen in the first quartile (47.24%) followed by the second (25.26%), fourth (14.88%), and third quartiles (0.74%). CONCLUSION: The Health Transformation Plan has been successful in increasing the cataract surgical rate in the low-income group and identifying differences in the services as well as the economic groups within the population.


Assuntos
Extração de Catarata , Catarata , Oftalmologia , Catarata/epidemiologia , Humanos , Irã (Geográfico)/epidemiologia
14.
Artigo em Chinês | MEDLINE | ID: mdl-35915944

RESUMO

Objective: To understand the lens condition of radiation workers in a city, explore the factors affecting lens opacity, and provide basis for strengthening the radiation protection management of radiation workers. Methods: In December 2020, according to the national radiation health monitoring project, the occupational health examination data of radiation workers in an occupational health examination institution in a city from December 2018 to November 2020 were collected, including the basic information of radiation workers and ophthalmic examination results. The lens conditions of radiation workers in different subgroups were analyzed, and the influencing factors of lens opacity were analyzed by multifactor logistic regression. Results: A total of 4452 radiation workers were included, of which 439 (9.9%) had lens opacity. The lens opacity rate of male radiation workers was higher than that of female radiation workers (P<0.05) . With the increase of age and length of service, the lens abnormalities of radiation workers increased (r(s)=0.269, 0.212, P<0.01) . The lens opacity rate of radiation workers engaged in nuclear medicine was high (12.7%, 9/71) . The rate of lens opacity in off-the-job medical examination radiation workers was high (18.3%, 26/142) . By multivariate logistic regression analysis, the risk of lens opacification in the age ≤30-year-old group and the >30-<50-year-old group were 0.087 times (95%CI: 0.058-0.132) and 0.076 times (95%CI: 0.054-0.107) that in the age ≥50-year-old group, respectively. The risk of lens opacification in the age ≤10-year-old group, >10-<20-year-old group and 20-30-year-old group were 0.293 (95%CI: 0.189-0.456) , 0.413 (95%CI: 0.256-0.666) and 0.318 (95%CI: 0.204-0.497) times, respectively. Conclusion: The lens opacity rate of radiation workers is related to age and working age.Attention should be paid to high-age and long-term radiation workers to ensure their health.


Assuntos
Catarata , Cristalino , Exposição Ocupacional , Proteção Radiológica , Adulto , Catarata/epidemiologia , Catarata/etiologia , Criança , Feminino , Pessoal de Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Exposição Ocupacional/efeitos adversos , Adulto Jovem
15.
Indian J Ophthalmol ; 70(8): 2862-2865, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35918931

RESUMO

Purpose: Phacoemulsification with intraocular lens (IOL) implantation is the standard of care for cataractous eyes. Monofocal IOLs are spherical or aspheric. The aspheric design of IOLs reduces the spherical and higher-order aberrations and impacts contrast sensitivity post cataract surgery. There are some studies, but data in the Indian setting with the IOLs we used is lacking. We aimed to compare the effect of implantation of spheric and aspheric foldable intraocular lenses on postoperative quality of vision, spherical aberration, and contrast sensitivity. Methods: This prospective observational study was conducted at a tertiary care hospital with an ophthalmology specialty, data collection from January 2017 to May 2018 in 100 patients. Patients meeting the inclusion criteria were selected. Their preoperative and postoperative data were collected and divided into groups based on whether spherical or aspheric IOL was implanted after cataract surgery. Variables assessed were visual acuity on days 7 and 30, spherical aberrations, and contrast sensitivity was assessed at 1-month postoperative. Results: The mean age of the patients in this study was 64 ± 8 years with a majority of patients (60%) being females. There is no significant difference in postoperative visual acuity between the two groups. Internal SA was significantly lower (~50%) in eyes implanted with aspheric IOLs (P value = 0.004, 0.0001) compared with the spherical group. Contrast sensitivity of patients of the aspheric group was significantly better (P value <0.05). Conclusion: The optical design of the aspheric IOLs reduced spherical aberrations and increased contrast sensitivity.


Assuntos
Catarata , Lentes Intraoculares , Facoemulsificação , Idoso , Sensibilidades de Contraste , Feminino , Humanos , Implante de Lente Intraocular , Masculino , Pessoa de Meia-Idade , Desenho de Prótese , Pseudofacia
16.
Indian J Ophthalmol ; 70(8): 3045-3049, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35918970

RESUMO

Purpose: Herein, we compared the efficacy among the Ocular Trauma Score (OTS), Toddlers Ocular Trauma Score (TOTS), and Pediatric Ocular Trauma Score (POTS) for prognosis prediction in Indian children who had mechanical ocular conditions causing traumatic cataract. Methods: This prospective, interventional study recruited consecutive children undergoing operation for traumatic cataracts caused by mechanical eye injuries at Drashti Netralaya. The following details were obtained from their medical files: the circumstance and time of injuries, penetrating injury type, initial and final visual acuity (VA), time of operation, and associated eye diseases. Specific variables were employed to determine the OTS, TOTS, and POTS. For all patients, the final and predicted VA determined using all scores were compared using Fischer's exact test. Accuracy, specificity, and sensitivity were evaluated for all the scores by using the area under receiver operating characteristic curve. Results: We enrolled 124 eyes. Patients' mean value for age was 4.6 ± 1.29 years; 44 (35.41%) and 74 (64.5%) were female and male patients, respectively. Visual outcomes significantly improved after operation, and the outcomes did not differ between closed- and open-globe injuries (P = 0.162). The actual and predicted VA did not exhibit a statistically significant difference among the three scores. TOTS and POTS were more suitable for evaluating low-risk injuries, whereas the OTS could more efficiently examine high-risk cases. Conclusion: TOTS and POTS were more accurate than the OTS in VA prediction after operation in toddlers with traumatic cataracts caused by mechanical globe injury. TOTS and POTS were more suitable for evaluating low-risk injuries, whereas the OTS could more efficiently examine high-risk cases. All the examined scores can be helpful in estimating VA following treatment.


Assuntos
Catarata , Ferimentos Oculares Penetrantes , Traumatismos Oculares , Catarata/diagnóstico , Catarata/etiologia , Pré-Escolar , Traumatismos Oculares/complicações , Ferimentos Oculares Penetrantes/complicações , Ferimentos Oculares Penetrantes/diagnóstico , Ferimentos Oculares Penetrantes/cirurgia , Feminino , Humanos , Masculino , Prognóstico , Estudos Prospectivos , Estudos Retrospectivos , Índices de Gravidade do Trauma , Acuidade Visual
20.
PLoS One ; 17(8): e0272369, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35930578

RESUMO

PURPOSE: To analyze ocular biometric changes following unilateral cataract surgery in children. METHODS: A total of 57 children aged under 13 years who underwent unilateral cataract surgery were analyzed. Groups were classified according to their age at surgery: group I (age <3), II (3≤ age <6), III (6≤ age <9), and IV (age ≥9). The myopic shift, axial growth, and corneal curvature changes were compared between the pseudophakic eyes and the fellow phakic eyes. RESULTS: During 7.81 ± 4.39 years, the overall myopic shift (D) and the rate of myopic shift (D/year) were significantly higher at -3.25 ± 3.21 D and -0.45 ± 0.44 D/year in the pseudophakic eyes than -1.78 ± 2.10 D and -0.22 ± 0.29 D/year in the fellow phakic eyes (P = 0.01, 0.004). Group I (-1.14 ± 0.66 vs -0.02 ± 0.45 D/year) and group II (-0.63 ± 0.37 vs -0.31 ± 0.29 D/year) showed significantly higher rate of myopic shift in the pseudophakic eyes than in the phakic eyes. The rate of myopic shift in the pseudophakic eyes decreased in the older age groups (P = 0.001). There was no significant between-eye difference in the changes in axial length and keratometric values postoperatively. CONCLUSION: Following unilateral cataract surgery, a significant postoperative myopic shift was noticed in the pseudophakic eyes compared to the fellow phakic eyes in groups under 6 years old. Postoperative myopic shift and the resultant anisometropia should be considered when selecting the optimal power of IOL in young children requiring unilateral cataract surgery.


Assuntos
Extração de Catarata , Catarata , Miopia , Idoso , Biometria , Criança , Pré-Escolar , Córnea , Seguimentos , Humanos , Implante de Lente Intraocular , Miopia/cirurgia , Refração Ocular
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